Organization Active NPI

Garden State Specialty Care, LLC

  • Surgery Physician
  • Northfield, NJ
National Provider Identifier
1356107916
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
GARDEN STATE SPECIALTY CARE, LLC
Practice address
1418 New Rd Ste 2
Northfield, NJ 08225-1179
Phone
(609) 796-7969
NPI assigned
Feb 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ayeza MohsinNPI 1619235264
Title
Medical Director
Phone
(609) 796-2119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1418 New Rd Ste 2
Northfield, NJ 08225-1179

Mailing address

1418 New Rd Ste 2
Northfield, NJ 08225-1179
Phone (609) 642-2663

Other practice location 1

301 Central Ave Ste D
Egg Harbor Township, NJ 08234-8347
Phone (609) 926-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170614000813 NJ Part B Supplier - Clinic/Group Practice 4385912492 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hackensack, NJ; Lakewood, NJ; Northfield, NJ; Parsippany, NJ; Edison, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

9822 Tapestry Park Cir
Ste 208
Jacksonville, FL 32246

3 State Route 27
Ste 106B
Edison, NJ 08820
Phone (201) 751-2202

1195 Highway 70
Ste 1005
Lakewood, NJ 08701
Phone (201) 751-2202

2106 New Rd
Ste F1
Linwood, NJ 08221
Phone (609) 699-5750

1418 New Rd
Northfield, NJ 08225
Phone (609) 272-1133

631 Shore Rd
Ste 3
Somers Point, NJ 08244
Phone (609) 469-1585

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751414400000",
    "number": "1356107916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 NEW RD STE 2",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251179",
            "telephone_number": "609-642-2663",
            "fax_number": "609-642-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 NEW RD STE 2",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251179",
            "telephone_number": "609-796-7969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Central Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Egg Harbor Township",
            "state": "NJ",
            "postal_code": "082348347",
            "country_code": "US",
            "telephone_number": "609-926-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARDEN STATE SPECIALTY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-22",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A",
        "authorized_official_last_name": "MOHSIN",
        "authorized_official_first_name": "AYEZA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-796-2119"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.